Pharmacy Call Center Specialist (Temp) at Abarca Health

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Full Time

Start Date

Immediate

Expiry Date

07 Jan, 26

Salary

0.0

Posted On

09 Oct, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Pharmacy Technician, Customer Service, Communication Skills, Bilingual, Problem Solving, Administrative Skills, Eligibility Support, Coverage Determination, Call Management, Complaint Resolution, Manual Reversal Requests, Federal Guidelines, PBM Experience, Medicare Part D, Insurance Knowledge, Healthcare Experience

Industry

Hospitals and Health Care

Description

What you’ll do In a few words… Abarca is igniting a revolution in healthcare. We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning… Providing high quality services to client and beneficiaries is at the core of what we do every day! The PBM Operations & Services team is the very heart of Abarca and meets that standard by running services from MTM, price eligibility, configurations, and beneficiary services to government services and beyond. Rx Customer Service leads the front lines in conducting satisfaction surveys, addressing complaints, managing manual reversal requests and other needs for our beneficiaries, pharmacies, and clients. As the Associate Rx Customer Service Specialist, you will serve at the front line of all incoming and outgoing communication (calls, emails, and faxes) with pharmacies, beneficiaries, and prescribers. You will use Rx Platform and other resources as necessary to resolve caller’s needs. The fundamentals for the job… Manage all incoming calls, emails, faxes and web-generated requests from pharmacies, beneficiaries, and prescribers. Provide service-level standards set by CMS or by client; 80% of calls should fall within service level, less than 5% abandon rate and speed to answer should be less than 30 seconds. Rejection support, including overrides. Provide Coverage Determination status to clients including exceptions and appeals. Administrative PAs- Document PA request inquiries, issues, status, and resolution in accordance with federal and department and company policies and guidelines. Answer questions and recommend corrective services to address customer complaints, payment status, manual reversal requests, benefit and eligibility support, provider portal support and response to price appeals. Report identified issues to the appropriate department, for investigation and correction, following the established procedure. What we expect of you The bold requirements… Pharmacy Technician Associate Degree (In lieu of a degree, equivalent relevant work experience may be considered.) 1+ years of experience working in a Pharmacy or Member Services Call Center, Retail or Hospital Pharmacy Setting. Excellent oral and written communication skills, bilingual fluency in English is required. We are proud to offer a flexible hybrid work model which will require certain on-site work days (Puerto Rico Location Only). This position requires open availability, including nights, weekends, and holidays, to support business needs. Nice to haves… Experience in PBM, Medicare Part D, Commercial/Employer Plans, Insurance, Pharmacy, and / or healthcare. Active pharmacy technician license. Call center experience. Physical requirements… Must be able to access and navigate each department at the organization’s facilities. Sedentary work that primarily involves sitting/standing. At Abarca we value and celebrate diversity. Diversity, equity, inclusion, and belonging are guiding principles of Abarca and ensure Abarca’s workforce reflects the communities it serves. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. Abarca Health LLC is an equal employment opportunity employer and participates in E-Verify. “Applicant must be a United States’ citizen. Abarca Health LLC does not sponsor employment visas at this time.” The above description is not intended to limit the scope of the job or to exclude other duties not mentioned. It is not a final set of specifications for the position. It’s simply meant to give readers an idea of what the role entails. #LI-REMOTE #LI-MH1

Responsibilities

Manage all incoming and outgoing communications with pharmacies, beneficiaries, and prescribers. Provide support for various inquiries including coverage determination, complaints, and administrative requests.